Illegal kidney trade thrives in Pakistan

By Muhammad Najeeb Islamabad, July 20 (IANS) In what seems to be a sub-continental malaise, illegal trade in kidneys is thriving in Pakistan, like it does in parts of neighbouring India. For many poor Pakistanis, selling a kidney has become a major “business” to meet their expenses and to pay off their loans, hospital sources and civil society organizations say.

Under the law, trade in human organs is illegal but, going by figures provided by different hospitals, an average of 30 people, including women, throughout the country sell their kidneys every month under the guise of “donations”.

“I’ve been offered Rs.80,000 ($1,500) for my kidney,” Rafiq Hussain, who has come here from Sialkot in Punjab to sell his kidney, told IANS.

He said he would use the money for paying off a loan or else he would have to give one of his daughters in marriage to a landlord who has loaned him money for the last 10 years.

“In 1997, I got Rs.10,000 from a landlord and more and more later to meet my needs,” Hussain said, refusing to name the landlord.

Hussain, in fact, lauded the landlord for “just asking for the (principal) amount without any interest”.

“I was informed by his manager to either return the money before August or marry off my daughter to the landlord, who already has two wives,” Hussain said, adding that he had no option but to sell his kidney.

He said he first went to Lahore to sell his kidney but was offered a very low price as compared to Islamabad.

“I’ve already got Rs.60,000 and Rs.20,000 will be paid after the operation,” he said, displaying no fear over losing one of his kidneys.

A doctor IANS spoke to found nothing wrong with the “donation” route.

“We talk to each and every donor and get him to sign a consent form before we perform an operation. I know (an illegal) trade is going on, but all these people sign a document saying they are willingly donating an organ,” said Sami Ahmed, one of several surgeons conducting kidney transplants.

Arguing in favour of donations, he said: “So far, I’ve conducted 137 operations and none of the donors has faced any problems. This is saving the lives of ailing people who could die if their kidneys are not replaced.”

NGO CARE that is working against the sale of human organs has a different point of view.

“Most of the kidney transplants are conducted on rich Pakistanis and foreigners with the donors getting far less than what the doctors charge for the operation,” CARE director Veena Kashif said.

“According to our survey, the surgeon gets between two and three lakhs (Rs.200,000-Rs.300,000), while about one lakh goes to the middleman and only Rs.50,000 to 70,000 on an average is paid to the seller,” she said.

According to Kashif, her organization was making every effort to stop the illegal kidney trade.

“Why don’t people get kidneys from their close relatives? Why is it that only poor people have to lose their organs for the wealthy people?” she wondered.

Kashif lamented that the so-called donors were not cooperating with her in making out a legal case against the doctors and middlemen who are the major beneficiaries of the trade.

On an average, a kidney transplant costs between Rs.400,000 and Rs.500,000 - depending on the surgeon and the hospital involved.

And, after the operation, the donors are pushed into a common ward and sent home just a day later, those who receive a transplant are kept in special rooms for five to seven days, a nurse in the Kidney Hospital in Rawalpindi told IANS.

She said that during her eight years with the hospital, no donor had died in the hospital but many patients who had got a transplant had died in the hospital.

An Australian kidney specialist recently sparked a bitter ethics row by calling for organ sales to be legalised to stop patients travelling overseas to buy them in the black market.

Nephrologist Gavin Carney said Australia should allow the sale of organs - which currently attracts a penalty of six months in jail and a $4,400 dollar (US $4,092) fine - to help bring down the bloated transplant waiting list.

Commenting on the issue Sami said that this should be legalized but with certain conditions like the donors’ health bill being paid by the kidney recipient.

According to Pakistani law, only close relatives or volunteers can donate their organs and a committee of experts has to certify that the donation was voluntary.

The law mandates action against any physician guilty of violating the laws and lays down a 10-year jail sentence for anyone involved in commercial trading of organs.

So far, five doctors have been arrested for their involvement in the illegal organ trade but all of them were bailed out within a few days of their arrest.